Individual
MRS. THERESA ANN FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN,SANE-P
Contact information
Practice address
1500 COOPER ST, FT WORTH, TX 76104-2710
(682) 885-3953
Mailing address
1500 COOPER ST, FT WORTH, TX 76104-2710
(682) 885-3953
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
625970
TX
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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